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Testicular Ultrasound

Testicular Ultrasound

Test Overview

A testicular ultrasound (sonogram) is a test that uses reflected sound waves to produce a picture of the testicles and scrotum. An ultrasound can show the long, tightly coiled tube that lies behind each testicle and collects sperm (epididymis) and the tube (vas deferens) that connects the testicles to the prostate gland. The ultrasound does not use X-rays or other types of radiation.

A small handheld instrument called a transducer is passed back and forth over the scrotum. The transducer sends the sound waves to the computer, which converts them into a picture that is displayed on a video monitor. The picture produced by ultrasound is called a sonogram, echogram, or scan. Pictures or videos of the ultrasound images may be saved as a permanent record.

Why It Is Done

Testicular ultrasound is done to:

  • Evaluate a mass or pain in the testicles.
  • Identify and monitor infection or inflammation of the testicles or epididymis.
  • Identify twisting of the spermatic cord cutting off blood supply to the testicles (testicular torsion).
  • Monitor for recurrence of testicular cancer.
  • Locate an undescended testicle.
  • Identify fluid in the scrotum (hydrocele), fluid in the epididymis (spermatocele), blood in the scrotum (hematocele), or pus in the scrotum (pyocele).
  • Guide a biopsy needle for testicular biopsy when testing for infertility.
  • Evaluate an injury to the genital area.

How To Prepare

No special preparation is needed for a testicular ultrasound.

If you are having a biopsy or another test during the ultrasound, you may need to sign a consent form.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

How It Is Done

A testicular ultrasound is usually done by an ultrasound technologist. It is done in an ultrasound room in a doctor's office or hospital.

You will need to remove all your clothes from the waist down and put on a gown before the test. You will be asked to lie on your back on a padded examination table. Folded towels will be used to cover the penis and lift the scrotum. A gel (such as K-Y Jelly) will be spread on your scrotum for the transducer. The transducer is pressed against your skin and moved across your scrotum many times.

You will need to lie very still during the ultrasound scan. You may be asked to take a breath and hold it for several seconds during the scanning. Testicular ultrasound takes about 20 minutes.

When the test is finished, the gel is removed from your skin. You may be asked to wait until the radiologist has reviewed the information. The radiologist may want to do more ultrasound views.

How It Feels

The gel may feel cold when it is applied to your scrotum unless it is first warmed to body temperature. You will feel light pressure from the transducer as it passes over your scrotum. If the ultrasound test is being done to determine the extent of damage from a recent injury or to investigate testicular pain, the slight pressure of the transducer may be somewhat painful. You will not hear the sound waves.

If a biopsy is done during the ultrasound, you may experience slight discomfort when the sample is obtained.

Risks

There are no known risks associated with a testicular ultrasound test.

Results

A testicular ultrasound (sonogram) is a test that uses reflected sound waves to produce a picture of the testicles and scrotum.

Testicular ultrasound
Normal:

The testicles are normal in shape and size and are in the normal position.

There is no evidence of a noncancerous (benign) or cancerous (malignant) lump in the testicles.

There is no evidence of infection or inflammation of the testicles or epididymitis.

There is no twisting of the spermatic cord, cutting off blood supply to the testicles (testicular torsion).

There is no sign of fluid in the scrotum (hydrocele), blood in the scrotum (hematocele), fluid in the epididymis (spermatocele), or pus in the scrotum (pyocele).

Abnormal:

A lump is present in the testicle or there are signs of a recurrent testicular cancer.

Signs of infection or inflammation of the testicles or epididymis is present.

The spermatic cord is twisted, cutting off blood supply to the testicles (testicular torsion).

None or only one testicle is present in the scrotal sac.

Fluid (hydrocele), blood (hematocele), or pus (pyocele) is present in the scrotum or fluid is present in the epididymis (spermatocele).

There is a hernia in the scrotum.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • Not being able to remain still during the test.
  • Having an open sore or wound in the area that needs to be viewed.

What To Think About

  • Testicular ultrasound is usually done to evaluate a mass or pain in the testicles for possible cancer. Young men with a testicular mass or pain should be evaluated immediately by a doctor. Testicular cancer is the most common cancer in young men.
  • With testicular ultrasound, your doctor can usually tell the difference between a fluid-filled cyst, a solid lump, or another type of mass.
    • A fluid-filled mass that has a symmetrical shape and does not have particles floating in it is likely to be a cyst or a hydrocele.
    • A mass that does not have fluid, one that has fluid with floating particles (atypical cyst), or one that is larger than expected needs further evaluation. Often a follow-up ultrasound is done in 6 to 8 weeks to allow time for the mass to go away on its own.
    • If a solid lump or an atypical cyst is present and a testicular ultrasound cannot determine whether it is cancer, a biopsy may be recommended.

References

Other Works Consulted

  • Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology
Current as of December 28, 2012

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